Discomfort of noninvasive ventilation, high flow nasal cannula oxygen, and conventional oxygen implemented after extubation in non-COPD patients
Abstract
BACKGROUND: Discomfort of noninvasive respiratory supports remain controversial. In the present study, the discomfort of high flow nasal cannula oxygen, noninvasive ventilation, and conventional oxygen therapy were evaluated in the post-extubation period. METHODS: Noninvasive ventilation alternating with high flow nasal cannula oxygen or conventional oxygen therapy were implemented for 48 h following extubation in patients free of chronic obstructive pulmonary disease. Using a 10-cm visual analog scale, the discomfort of the interface (oxygen mask, nasal prongs or facial mask), was self-evaluated by 264 patients after extubation whereas the discomfort of the respiratory support (conventional oxygen therapy or high flow nasal cannula oxygen alternating with noninvasive ventilation) was evaluated by the nurses in 306 patients. Evaluations were performed in patients at high (n = 127) and low (n = 179) risk of postextubation respiratory failure, 6, 24 and 48 h after extubation. RESULTS: Facial mask was the source of a significant and persisting self-evaluated discomfort. Nasal prongs and oxygen mask were less uncomfortable, with a progressive reduction of the discomfort with time. High flow nasal cannula oxygen alternating with noninvasive ventilation caused a significant and persisting nurse-reported discomfort. Conventional oxygen therapy was significantly less uncomfortable, and the degree of discomfort was not different in patients at high and low risk of extubation failure. CONCLUSIONS: Noninvasive ventilation was associated with a significant and persisting discomfort whereas high flow nasal cannula oxygen-induced discomfort remained limited. After 48 h, discomfort resulting from high flow nasal cannula oxygen and conventional oxygen therapy was similar and negligible.
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BibTeX
@article{rouby2026discomfort,
title = {{Discomfort of noninvasive ventilation, high flow nasal cannula oxygen, and conventional oxygen implemented after extubation in non-COPD patients}},
author = {Jean-Jacques Rouby and Jean-Pierre Quenot and Mao Zhang and Sébastien Perbet and Jie Lv and Mona Assefi and Jean-Michel Constantin and Xia Jing and Dominique Morand and Bruno Pereira and Nicolas Adam and Charlotte Arbelot and Romain Deransy and Louis Puybasset and Marine Lecorre and Hélène Brisson and Antoine Monsel and Emmanuel Futier and Matthieu Jabaudon and Russel Chabanne and Sylvia Collomb and Pascal Andreu and Marie Labruyère and Jean-Baptiste Roudaut and Marine Jacquier and Yuzi Gao and Youzhong An and Shan Lyu and Chuanyun Qian and Yang Ting and Julien Birckener and Laura Chenard and Benoît Longère and Pierre Eric Danin and Jean-François Payen de la Garanderie and Florent Wallet and Luiz Malbouisson and Felippe Dexheimer},
journal = {Critical Care},
year = {2026},
month = may,
doi = {10.1186/s13054-026-06104-8},
url = {https://hal.science/hal-05751888v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Discomfort of noninvasive ventilation, high flow nasal cannula oxygen, and conventional oxygen implemented after extubation in non-COPD patients
AU - Jean-Jacques Rouby
AU - Jean-Pierre Quenot
AU - Mao Zhang
AU - Sébastien Perbet
AU - Jie Lv
AU - Mona Assefi
AU - Jean-Michel Constantin
AU - Xia Jing
AU - Dominique Morand
AU - Bruno Pereira
AU - Nicolas Adam
AU - Charlotte Arbelot
AU - Romain Deransy
AU - Louis Puybasset
AU - Marine Lecorre
AU - Hélène Brisson
AU - Antoine Monsel
AU - Emmanuel Futier
AU - Matthieu Jabaudon
AU - Russel Chabanne
AU - Sylvia Collomb
AU - Pascal Andreu
AU - Marie Labruyère
AU - Jean-Baptiste Roudaut
AU - Marine Jacquier
AU - Yuzi Gao
AU - Youzhong An
AU - Shan Lyu
AU - Chuanyun Qian
AU - Yang Ting
AU - Julien Birckener
AU - Laura Chenard
AU - Benoît Longère
AU - Pierre Eric Danin
AU - Jean-François Payen de la Garanderie
AU - Florent Wallet
AU - Luiz Malbouisson
AU - Felippe Dexheimer
PY - 2026
DA - 2026/05/31
JO - Critical Care
DO - 10.1186/s13054-026-06104-8
UR - https://hal.science/hal-05751888v1
AB - BACKGROUND: Discomfort of noninvasive respiratory supports remain controversial. In the present study, the discomfort of high flow nasal cannula oxygen, noninvasive ventilation, and conventional oxygen therapy were evaluated in the post-extubation period. METHODS: Noninvasive ventilation alternating with high flow nasal cannula oxygen or conventional oxygen therapy were implemented for 48 h following extubation in patients free of chronic obstructive pulmonary disease. Using a 10-cm visual analog scale, the discomfort of the interface (oxygen mask, nasal prongs or facial mask), was self-evaluated by 264 patients after extubation whereas the discomfort of the respiratory support (conventional oxygen therapy or high flow nasal cannula oxygen alternating with noninvasive ventilation) was evaluated by the nurses in 306 patients. Evaluations were performed in patients at high (n = 127) and low (n = 179) risk of postextubation respiratory failure, 6, 24 and 48 h after extubation. RESULTS: Facial mask was the source of a significant and persisting self-evaluated discomfort. Nasal prongs and oxygen mask were less uncomfortable, with a progressive reduction of the discomfort with time. High flow nasal cannula oxygen alternating with noninvasive ventilation caused a significant and persisting nurse-reported discomfort. Conventional oxygen therapy was significantly less uncomfortable, and the degree of discomfort was not different in patients at high and low risk of extubation failure. CONCLUSIONS: Noninvasive ventilation was associated with a significant and persisting discomfort whereas high flow nasal cannula oxygen-induced discomfort remained limited. After 48 h, discomfort resulting from high flow nasal cannula oxygen and conventional oxygen therapy was similar and negligible.
SN - 1364-8535
SN - 1466-609X
ER -